This weekend was the joint American Society of Cataract and Refractive Surgery (ASCRS) / University of California, Los Angeles (UCLA) conference in Century City. Some of the most impressive cataract surgeons from North America presented their findings on the latest advancements in cataract and refractive surgery.
The new intraocular lens study results created quite a buzz among the attendees. None of these IOLs will be available in the USA for at least another year or so. Nevertheless, anyone who is on the fence about their cataract surgery might consider waiting as their options will only get better as these new IOLs become available.
Today I will discuss the most revolutionary design change in IOL technology, the Calhoun light-adjustable IOL. Over this next week, I will write about the exciting IOLs that were presented at this meeting.
Although this lens is not a presbyopia-correcting IOL (more on that in my later posts), this lens embodies what is probably the most exciting and revolutionary technology on the horizon for cataract surgery.
Presently, when someone needs cataract surgery the surgeon chooses the IOL based on measurements taken of the cornea and size of the eye. However, the calculations used to choose the IOL are “best estimates” of what that particular patient will need. They don’t work for everyone. Additionally, IOLs come in 1/2 diopter increments meaning that the best we can possibly hope for is that the post-surgical refractive error will be plus or minus 1/4 diopter. It’s like buying shoes: if you have a 10 1/4 foot it will be a bit too large for a size 10 shoe and too small for a 10 1/2.
Unlike buying shoes, however, your don’t get to try on an IOL before buying. It’s a lot like having a shoe salesman measure your foot and forcing you to buy the shoe he thinks will fit without trying it on. Oh, and there is a no return policy. Would this make you uncomfortable buying a shoe? Welcome to the life of a cataract surgeon – present IOL technology forces us to choose the IOL for the patient without really knowing (beyond what the measurements suggest) what they will finally need.
Enter the light-adjustable IOL. This amazing technology allow the surgeon to adjust the strength of the IOL after surgery using an ultraviolet light. Even astigmatism can be corrected. Once the post-operative refractive error has been minimized, the strength of the IOL can be “locked-in.” After this is done there would be no need for distance glasses. Reading, however, would still require “cheaters.”
Of course, this technology will probably be quite expensive so don’t expect Medicare or most insurances to pick up the cost of these adjustments. How much will it cost? That’s unknown at this time. Since the IOL and the equipment to adjust the strength of the IOL has not been approved yet the company has not released pricing information. Although this is a shot in the dark, I would expect it to be at least $1,000 extra just for the IOL and another $1,000-2,000 for the surgeon’s fee.
Tomorrow I’ll discuss what I think is the most exciting advancement in “presbyopia-correcting” IOL technology.
© 2009 David Richardson, MD